ESPE Abstracts

Background: Angiopoietin-2 is a growth factor involved in the pathophysiology of different vascular and inflammatory diseases such as arteriosclerosis. Carotid or aortic scans provide non-invasive screening tools for assessment of preclinical atherosclerosis in high-risk children.

Aim: We assessed serum angiopoietin-2 in children and adolescents with type 1 diabetes mellitus as a potential marker for diabetic vascular complications in relation to glycemic control, inflammation and vascular structure.

Methods: Sixty patients with type 1 diabetes were divided into 2 groups according to the presence of micro-vascular complications and compared with 30 healthy controls. High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), urinary albumin creatinine ratio, serum angiopoietin-2 levels, carotid and aortic intima media thickness (CIMT and AIMT) were measured.

Results: CIMT, AIMT and serum angiopoietin-2 levels were significantly increased in patients with and without micro-vascular complications compared with controls and the highest levels were in patients with complications (P<0.001). Serum angiopoietin-2 was higher in patients with microalbuminuria than normoalbuminuric group (P<0.001). The cutoff value of serum angiopoietin-2 at 900 pg/ml could differentiate patients with and without micro-vascular complications with a sensitivity of 92.3% and specificity of 100%. The cutoff values for CIMT and AIMT to detect micro-vascular complications were determined. Multiple regression analysis showed that fasting blood glucose, HbA1c, hs-CRP, CIMT and AIMT were independently related to angiopoietin-2.

Conclusion: The relation between angiopoietin-2 and assessed parameters of vascular structure in type 1 diabetes reflects a state of subclinical atherosclerosis and highlights the role of disturbed angiogenesis and vascular inflammation in the occurrence of diabetic complications.